Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI System > Liver & The Biliary System > Flashcards

Liver & The Biliary System Flashcards

1
Q

What are the 3 main broad functions of the liver?

A
  1. Storage - Glycogen, Vitamins, Iron, Copper
  2. Synthesis - Glucose, Protein, Lipids, Cholesterol, Bile
  3. Metabolism / Detoxification - Bilirubin, Ammonia, Drugs, Alcohol, Carbs, Lipids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the general symptoms of liver disease?

A
  • Nausea
  • Vomiting
  • Fatigue
  • Anorexia
  • Abdominal Pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What can a defect in bilirubin metabolism lead to?

A

Jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What can a defect in Ammonia metabolism lead to?

A

Confusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can a defect in albumin synthesis lead to?

A

Odema / Ascites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What can a defect in synthesis of clotting factors lead to?

A

Bleeding / Easy Bruising

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What kind of things can cause acute liver failure?

A
  • Paracetamol overdose
  • Other medications e.g. tetracycline, aspirin in children
  • Acute Viral Infection e.g. EBV, CMV, Hep A/B
  • Acute excessive alcohol intake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What do all chronic liver diseases end with?

A

Cirrhosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does cirrhosis arise?

A
  • Ongoing inflammation causes fibrosis
  • Associated hepatocyte necrosis
  • Causes architectural changes nodules
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 3 main mechanisms by which alcohol can affect the liver?

A
  1. Fatty Change (weeks)- as more TAG made and deposited in the liver, initially reversible
  2. Alcoholic Hepatitis (years)- initially reversible
  3. Cirrhosis (years) - end stage, irriversible damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does alcoholic hepatitis present?

A
  • Rapid onset Jaundice
  • Tender Hepatomegaly (RUQ pain)
  • Nausea
  • Oedema
  • Ascites
  • Splenomegaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the 2 main viruses that cause Viral Hepatitis?

A

Hep B - Double stranded DNA virus

Hep C - Single stranded RNA virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is non-alcoholic fatty liver disease (NAFLD)?

A

An accumulation of triglycerides and other lipids in hepatocytes

Similar pathogenesis to Alcoholic Liver Disease without the alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What kind of things increase risk of non-alcoholic fatty liver disease?

A
  • Obesity
  • Diabetes
  • Metabolic Syndrome (dyslipidaemia)
  • Familial Hyperlipidaemia

Due to link with insulin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Hereditary Haemochromatosis? How does it occur?

A

An abnormality of iron metabolism

  • Increased absorption of iron from the small intestine causing excess depostion
  • Autosomal recessive disorder
  • Increased ferratin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do you treat Hereditary Haemochromatosis?

A

Venesection treatment to remove iron load from the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is Wilson’s Disease? How does it occur?

A

An abormality in Copper Metabolism

  • Autosomal recessive disorder
  • Reduced Copper secretion from the biliary system causes an accumulation in tissues
  • Low Caeruloplasmin
18
Q

What are some auto-immune causes of liver cirrhosis?

A
  1. Autoimmune Hepatitis
  2. Primary Biliary Cirrhosis
  3. Primary Sclerosing Colangitis
19
Q

What veins form the portal vein?

A
20
Q

What is portal hypertension?

A

A build up of blood in the portal venous sytem

21
Q

What is the effect of a fibrotic liver on the portal venous system?

A
  • Fibrotic liver not very expansive
  • Compresses veins entering liver from portal venous system
  • Increased hydrostatic pressure causes fluid to be forced out of veins → ascites
  • Increased build up of pressure in splenic circulation → splenomegaly
22
Q

What are the 3 most important sites of varices in portal hypertension?

A
  1. Oesophageal
  2. Anorectal
  3. Umbilical
23
Q

Where are oesophageal varcies located and what can happen to them?

A
  • Locted in the upper 2/3 of the oesophagus
  • Can lead to mucosal varcies
  • If rupured can cause significan haematemesis
24
Q

Where are anorectal varices usually located?

A

Between the superior rectal and middle/ inferior rectal veins and the anus

25
Q

Why are anorectal varices usually painless?

A

As they are above the dendate line and have visceral pain which is poorly localised

26
Q

What is caput medusa?

A

When blood flows through the ligamentum teres (usually has no blood flow) during portal hypertension, causing superficial veins of the abdominal wall to distend

27
Q

What is Hepatorenal Syndrome?

A

The development of Acute Kidney Injury in the presence of cirrhosis

28
Q

Describe the pathophysiology of Hepatorenal syndrome

A
  1. Portal Hypertension
  2. Splanchnic artery vasodilation
  3. RAAS activated
  4. Renal artery vasconstriction reduces blood flow to the kidney
29
Q

Label the Biliary Tree

A
30
Q

What are gallstones formed from?

A

Either:

  • Cholesterol
  • Bile Pigments
  • Or a mix of both
31
Q

Which diagnostic imaging procedure would you use to identify gallstones and why?

A

Ulstrasound

Gallstones are radiolucent so will not show on XRay

32
Q

What are some risk factors for developing gallstones?

A
  • Diet and lifestyle rich in fat and cholesterole
  • Age >40 years
  • Gender: Female > Male
  • Pregnancy due to stasis
  • Pre-existing liver disease
33
Q

What is the name given to temporary obstruction of the cystic duct that causes RUQ pain a few hours after eating a fatty meal?

A

Biliary Colic

34
Q

Why does the pain in biliary colic arise a few hours after eating a fatty meal?

A

Fatty food entering the duodenum triggers the release of CCK which causes the gallbladder to move which causes the pain as contents cannot escape

35
Q

How do you manage Biliary Colic?

A
  • Analgesia
  • Elective cholecystectomy
36
Q

What is acute cholecystitis?

A

An impacted stone in the cystic duct

  • initially similar presentation to biliary colic
  • Inflmmatory features seen on ultrasound → thickened gallbladder
  • Murphy’s Sign Positive
37
Q

What is Murphy’s Sign?

A
  • The liver, gallbladder and diaphragm are connected
  • On inspiration the diaphragm flattens, lowering the liver and gallbladder
  • In Murphy’s sign the Dr places their hand on the RHS of the abdomen, on inspiration it will cause pain
38
Q

What is acute ascending cholangitis?

A

An infection of biliary tree typically due to an impacted stone in the common bile duct

Presents with Charcot’s Triad: RUQ pain, fever, jaundice

39
Q

How do you manage acute ascending cholangitis?

A
  • IV antibiotics
  • Fluids
  • Relieve obstruction
40
Q

How can gallstones lead to acute pancreatitis?

A

Blockage of the pancreatic duct evokes an inflammatory response as contents cannot leave. Pancreatic enzymes start to autodigest the pancreas causing acinar cell injury and necrosis

41
Q

How does acute pancreatitis present?

A
  • Epigastric pain that radiates to the back
  • Often have vomiting
  • Cullen’s Sign (bruising down the tummy)
  • Grey Turner’s Sign (brusing down the flanks)

GI System (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions